Predicting change in relationship distress and depressive symptoms among couples in Taiwan: The role of attachment, emotional expressivity, and gender roles in Emotionally Focused Therapy.

This pilot study examined predictors of change in relationship distress and depressive symptoms over the course of Emotionally Focused Therapy (EFT) in a one-arm, pragmatic clinical trial of 17 couples in Taiwan. Results revealed that masculine ideology, feminine ideology, traditionalism, and emotional expressivity at intake predicted change in relationship distress. Specifically, women's high traditional gender roles and traditionalism and both partners' high emotional expressivity at intake were associated with decreases in relationship distress over time. In addition, attachment and emotional expressivity predicted change in depressive symptoms. Specifically, high attachment avoidance, high attachment anxiety, and high emotional expressivity at intake were associated with decreases in depressive symptoms over time. While more research is needed, these findings offer preliminary support for the types of partners who may experience more improvement after receiving EFT in Taiwan.

Exploring the effectiveness of emotionally focused therapy for depressive symptoms and relationship distress among couples in Taiwan: A single-arm pragmatic trial.

This is the first study to explore the effectiveness of emotionally focused couple therapy (EFT) for depressive symptoms and relationship distress among couples in Taiwan. This one-arm pragmatic trial assessed the clinical outcomes of 17 couples using multilevel modeling to investigate changes in depressive symptoms and relationship distress throughout treatment. Over half of the participants were moderately depressed and moderately distressed at baseline. Multilevel models revealed decreased depressive symptoms over time, with a small increase toward the end of treatment. However, no significant changes were observed in relationship distress over time. The study was limited by the low "dose" of EFT (M = 7 sessions) received by participants and the small sample size (n = 17). A comprehensive discussion of the findings from a cultural perspective was provided. Future research is needed to further examine the effectiveness of EFT for couples in Taiwan and Asia.

Session-to-session bidirectional associations of alliance with depressive symptoms and relationship satisfaction.

The relationship between therapeutic alliance and treatment outcomes is one of the most widely studied topics in psychotherapy research. Research has primarily considered a unidirectional model whereby alliance predicts outcomes, which implies that building alliance early in therapy results in later symptom improvement and ignores the possibility that early symptom improvement could also subsequently lead to improved alliance. This study explored the bidirectional associations of alliance and outcomes session-to-session for 15 sessions among a sample of 24 couples randomized to emotionally focused therapy or treatment as usual for depression and relationship dissatisfaction. Multilevel models tested associations between the prior week's alliance and the following week's clinical outcomes (i.e., depressive symptoms and relationship satisfaction) and the prior week's clinical outcomes with the following week's alliance. Findings indicated that the prior week's alliance was associated with the following week's relationship satisfaction, but not depressive symptoms, when controlling for the prior week's depressive symptoms and relationship satisfaction in each respective model. In addition, the prior week's depressive symptoms and relationship satisfaction were both associated with the following week's alliance, when controlling for the prior week's alliance. Only one of these associations differed by sex: previous week's higher relationship satisfaction was associated with higher therapeutic alliance the following week for males than females. These bidirectional associations did not differ by treatment condition. This study contributes to the emerging empirical support suggesting bidirectionality among alliance and treatment outcomes.

Effects of adding video feedback to emotionally focused therapy supervision: A concurrent multiple-baseline across subjects design.

Emotionally focused therapy (EFT) is an empirically supported intervention for relationship distress with an established model of supervision. This study examined whether incorporating video feedback (VF) software into EFT supervision would improve therapists' level of development compared to traditional EFT supervision in a university training clinic. A concurrent multiple-baseline across subjects design, along with a thematic analysis of qualitative data, were used in this proof-of-concept study of the new supervision component. Overall, quantitative findings suggested that using VF in EFT supervision resulted in some improvement to therapists' development, while qualitative findings showed that all participants supported the incorporation of VF into EFT supervision. Future research on VF is needed to provide additional insight into the use of video review supervision.

Couple and family interventions for depressive and bipolar disorders: Evidence base update (2010-2019).

This article systematically reviews the evidence base for couple and family interventions for depressive and bipolar disorders published from 2010 to 2019. Included in the review were intervention studies on depression for couples (n = 6), depression for families (n = 13), and bipolar for families (n = 5); zero studies on couple interventions for bipolar were located. Well-established interventions include cognitive and/or behavioral couple and family interventions for depression and psychoeducational family interventions for bipolar. Attachment-based couple and family interventions for depression are probably efficacious. Finally, family psychoeducation for depression is possibly efficacious, and integrative couple interventions and family play-based interventions for depression are experimental. Couple and family interventions also improved relationship dynamics, which is noteworthy since poor relationships are associated with non-remission, relapse, and recurrence of depressive and bipolar symptoms. Future research is needed on couple interventions for bipolar disorders and interventions for minoritized populations.

"There may be a problem, but I'm not going because ": examining classes of men and their rationales for not seeking mental health treatment.

BACKGROUND: Men are less likely than women to seek out mental health treatment, despite men also having mental health struggles. AIM: We examined typologies of men's reasons for not seeking treatment even though they perceived a need for treatment. METHOD: We conducted a latent class analysis using a U.S. national sample of 836 men who specifically indicated a need for mental health services, but did not seek treatment from the National Study on Drug Use and Health. RESULTS: We identified three distinct types of men and their unique rationales for not seeking treatment: positive attitudes class, perceived high behavioral control class, and negative attitudes class. CONCLUSIONS: Unique strategies to market clinical services to each of the various needs and concerns of these types of men may prove more beneficial than a generic outreach approach. We encourage mental health professionals to proactively educate men about their services and aim to reduce barriers for men seeking treatment.

You can tell me anything: Disclosure of suicidal thoughts and behaviors in psychotherapy.

Only half of clients disclose suicidal thoughts or behaviors in psychotherapy. Qualitatively, we sought to understand the experience of disclosing suicidal thoughts and behaviors (STBs) to clinicians and applied the disclosure processes model (Chaudoir & Fisher, 2010) to frame our findings. Participants (N = 68) responded to an anonymous, open-ended survey about their experience of disclosing or withholding recent STBs in therapy. Half of our sample (n = 34) withheld their STBs from their psychotherapist, whereas the other half (n = 34) disclosed. We coded primary themes of the disclosure process and framed these processes using the disclosure processes model framework. Motivations for nondisclosure primarily included fear of negative outcomes, particularly involuntary hospitalization. Motivations for disclosure included help-seeking intentions to address STBs and a positive therapist-client relationship. Clients' perceptions of psychotherapists' responses to the disclosure were described as supportive, the level of care was adjusted, or a lack of appropriate care was displayed. The findings of this study reveal common motivations for disclosing or withholding STBs and how psychotherapist responses to disclosures impact clients. Implications for promoting STBs disclosure in psychotherapy and responses to clients are included. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Sexual and Relationship Satisfaction associated with Shifts in Dyadic Trajectories of Depressive Symptoms in German Couples across Four Years.

Depression is a pervasive mental health concern; thus, it is important to identify modifiable factors associated with reducing depressive symptoms across time. Using 1,876 heterosexual couples assessed annually across 4 years from the Panel Analysis of Intimate Relationships and Family Dynamics (Pairfam) study, time-varying covariate growth models tested if sexual and relationship satisfaction were linked with shifts in trajectories of depressive symptoms across time. For both men and women, higher sexual and relationship satisfaction scores were significantly associated with decreasing their own depressive symptom trajectories, but only relationship satisfaction was linked with their partners' depressive symptom trajectories. Potential clinical implications include the treatment of depressive symptoms by making changes across time in their own relationship satisfaction and sexual satisfaction.